How much rates vary
Facilitymedian $63 · 10th to 90th $55 to $182Professionalmedian $83 · 10th to 90th $56 to $141
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $54.95 Median $57.54 Typical High $83.18 | Facility | None | $54.95 | $57.54 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $74.13 Typical High $117.49 | Professional | None | $56.23 | $74.13 | $117.49 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $95.50 Typical High $128.82 | Professional | None | $63.10 | $95.50 | $128.82 |
AmeriHealth Setting Professional Modifier None Typical Low $63.10 Median $74.13 Typical High $87.10 | Professional | None | $63.10 | $74.13 | $87.10 |
Capital Blue Cross Setting Facility Modifier None Typical Low $4,265.80 Median $5,011.87 Typical High $79,432.82 | Facility | None | $4,265.80 | $5,011.87 | $79,432.82 |
Capital Blue Cross Setting Professional Modifier None Typical Low $83.18 Median $134.90 Typical High $169.82 | Professional | None | $83.18 | $134.90 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $75.86 Typical High $128.82 | Professional | None | $64.57 | $75.86 | $128.82 |
Emblem Health Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Emblem Health Setting Professional Modifier None Typical Low $42.66 Median $112.20 Typical High $158.49 | Professional | None | $42.66 | $112.20 | $158.49 |
Geisinger Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $75.86 | Facility | None | $63.10 | $63.10 | $75.86 |
Geisinger Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $144.54 | Professional | None | $67.61 | $93.33 | $144.54 |
Highmark BCBS Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Highmark BCBS Setting Professional Modifier None Typical Low $77.62 Median $91.20 Typical High $131.83 | Professional | None | $77.62 | $91.20 | $131.83 |
Independence Blue Cross Setting Professional Modifier None Typical Low $63.10 Median $75.86 Typical High $114.82 | Professional | None | $63.10 | $75.86 | $114.82 |
Martin's Point Setting Facility Modifier None Typical Low $54.95 Median $56.23 Typical High $83.18 | Facility | None | $54.95 | $56.23 | $83.18 |
Martin's Point Setting Professional Modifier None Typical Low $56.23 Median $74.13 Typical High $114.82 | Professional | None | $56.23 | $74.13 | $114.82 |
Optum Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $95.50 | Professional | None | $81.28 | $81.28 | $95.50 |
Oscar Health Setting Professional Modifier None Typical Low $72.44 Median $81.28 Typical High $138.04 | Professional | None | $72.44 | $81.28 | $138.04 |
UPMC Health Plan Setting Facility Modifier None Typical Low $75.86 Median $134.90 Typical High $199.53 | Facility | None | $75.86 | $134.90 | $199.53 |
UPMC Health Plan Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $79.43 | Professional | None | $75.86 | $75.86 | $79.43 |
United Setting Professional Modifier None Typical Low $61.66 Median $77.62 Typical High $138.04 | Professional | None | $61.66 | $77.62 | $138.04 |
15 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $27.54 Median $28.18 Typical High $31.62 | Facility | 52 · Reduced service | $27.54 | $28.18 | $31.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.32 Median $8.51 Typical High $9.33 | Facility | 55 · Aftercare only | $8.32 | $8.51 | $9.33 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.62 Typical High $6.31 | Facility | 56 · Pre-op care only | $5.50 | $5.62 | $6.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $28.18 Typical High $33.11 | Professional | 52 · Reduced service | $27.54 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.51 Typical High $10.00 | Professional | 55 · Aftercare only | $8.32 | $8.51 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.62 Typical High $6.61 | Professional | 56 · Pre-op care only | $5.50 | $5.62 | $6.61 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $102.33 Median $117.49 Typical High $144.54 | Professional | 25 · Same-day visit | $102.33 | $117.49 | $144.54 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $91.20 Median $112.20 Typical High $141.25 | Professional | GC · Resident with teaching physician | $91.20 | $112.20 | $141.25 |
Highmark BCBS Setting Professional Modifier GC · Resident with teaching physician Typical Low $81.28 Median $93.33 Typical High $134.90 | Professional | GC · Resident with teaching physician | $81.28 | $93.33 | $134.90 |
Martin's Point Setting Facility Modifier 52 · Reduced service Typical Low $27.54 Median $28.18 Typical High $31.62 | Facility | 52 · Reduced service | $27.54 | $28.18 | $31.62 |
Martin's Point Setting Facility Modifier 55 · Aftercare only Typical Low $8.32 Median $8.51 Typical High $9.33 | Facility | 55 · Aftercare only | $8.32 | $8.51 | $9.33 |
Martin's Point Setting Facility Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.62 Typical High $6.31 | Facility | 56 · Pre-op care only | $5.50 | $5.62 | $6.31 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $28.18 Typical High $29.51 | Professional | 52 · Reduced service | $27.54 | $28.18 | $29.51 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.51 Typical High $8.91 | Professional | 55 · Aftercare only | $8.32 | $8.51 | $8.91 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.62 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.50 | $5.62 | $5.89 |
Where Pennsylvania sits
The same service costs 2.3 times more in Alaska than in New Jersey. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Pennsylvania· 29th of 51
$81.28
AK $155NJ $67.61
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.